<div class="panel-header row">
    <div class="col-xs-8">
        <h2>Cập nhật thông tin</h2>
    </div>
    <div class="col-xs-4" style="padding-bottom:5px;">
        <img class="col-xs-8" id="avatar"src="<?php echo base_url(); ?>img/avatar.jpg" alt="">
    </div>
</div>
<form action="#" class="form-horizontal">
    <div class="panel panel-info">
        <div class="panel-heading">
            <h3 class="panel-title">Thông tin cá nhân</h3>
        </div>
        <div class="panel-body">
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="avatar">Hình đại diện</label>
                </div>

                <div class="col-xs-6">
                    <input type="file" id="avatar" accept="image/*">
                </div>
            </div>
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="name">Họ tên</label>
                </div>                        
                <div class="col-xs-4">
                    <input type="text" id="inputName" Class="form-control" placeholder="Họ tên">
                </div>
                <div class="col-xs-2">
                    <select class="form-control input-sm" id= "sex">
                        <option value="0">Giới tính</option>
                        <option value="1">Nam</option>
                        <option value="2">Nữ</option>
                    </select>
                </div>
            </div>
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="bDay">Ngày sinh</label>
                </div>                        
                <div class="col-xs-2">
                    <select class="form-control input-sm" id="day" >
                        <option value="0">Ngày</option>
                        <?php
                        for ($i = 1; $i <= 31; $i++) {
                            ?> 
                            <option value="<?php echo $i ?>"><?php echo $i; ?></option> 
                            <?php
                        }
                        ?> 
                    </select>
                </div>
                <div class="col-xs-2">
                    <select class="form-control input-sm" id="month">
                        <option value="0">Tháng</option>
                        <?php
                        for ($i = 1; $i <= 12; $i++) {
                            ?> 
                            <option value="<?php echo $i ?>"><?php echo $i; ?></option> 
                            <?php
                        }
                        ?>
                    </select>
                </div>
                <div class="col-xs-2">
                    <select class="form-control input-sm" id="year">
                        <option value="0">Năm</option>
                        <?php
                        for ($i = 2014; $i > 1970; $i--) {
                            ?> 
                            <option value="<?php echo $i ?>"><?php echo $i; ?></option> 
                            <?php
                        }
                        ?>
                    </select>
                </div>
            </div>
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="numPhone">Số điện thoại</label>
                </div>

                <div class="col-xs-6">
                    <input type="text" id="inputNumPhone" Class="form-control" placeholder="Số điện thoại">
                </div>

            </div>
            <div class="form-group row">
                <div class="col-xs-3">
                    <label class="control-label" for="address">Địa chỉ</label>
                </div>

                <div class="col-xs-6">
                    <input type="text" id="inputAddress" Class="form-control" placeholder="Địa chỉ">
                </div>

            </div>
            <div class="form-group">
                <div class="col-xs-3"></div>
                <div class="col-xs-3">
                    <button type="submit" class="btn btn-primary btn-sm btn-block">Thay đổi</button>
                </div>
                <div class="col-xs-2">
                    <button type="reset" class="btn btn-default btn-sm btn-block">Hủy</button>
                </div>


            </div>
        </div>
    </div>
</form>